The Roland Collection
Order Form - Worldwide

Please use an alternative form for orders from the USA.

Please print out this page now!

	Bill to		Ship to
organization		organization
department		department
address		address
city		city
area/code		area/code
country		country
telephone		telephone
fax		fax
email		email
date		date
purchase order number		for the attention of
for the attention of

Is the order for private [ ] or institutional [ ] use? (please tick box)

catalog number	title		Quantity required		price per title	total
catalog number	title		16mm film	VHS video	price per title	total









VAT UK clients should add VAT. Rest of Europe: add Value Added Tax at current UK rate unless you are VAT registered and inform us of your number. Check Please check availability details for the films or videos you wish to order - can your choice be supplied to your country?				Subtotal
				shipping and handling
				total
				VAT if applicable
				grand total

Shipping and handling - Worldwide
Film sale: courier charge	Video preview @ $7
Video sale @ $7	Books @ $7
8 or more @ $3.50	Resource guide @ $8

payment by	Access O Visa O Mastercard O American Express O
credit card number	_ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ expiry date __ / ____
cardholder's name	_________________________________________
cardholder's signature	_________________________________________

Please send your order to :

UK and Worldwide	USA only

The Roland Collection Peasmarsh East Sussex TN31 6XJ Telephone: 01797 230 421 Intl: +44 1797 230 421 Fax: 01797 230 677 Intl: +44 1797 230 677 Email: sales@roland-collection.co.uk	The Roland Collection 22-D Hollywood Avenue Ho-Ho-Kus New Jersey 07423 Telephone: 201 251 8200 Fax: 201 251 8788